The PerfWeb Podcast

Excellent discussion and review of opinions and data from key opinion leaders in the area of cardiac surgery. Discussions about patient outcomes, safety, effectiveness, advantages, disadvantages, appropriateness, and when an off-pump or on-pump technique should be considered.

ECMO (Extracorporeal Membrane Oxygenation) patient selection is a complex and often difficult decision for any healthcare provider that orders or decides on the appropriateness of ECMO therapy for their patients. Learn the absolute inclusion and exclusion criteria, but also learn from the discussions about the relative indications and contraindications from a group of ECMO leaders and experts.

Panel discussion about hyperkalemia while coming off bypass. There exists a lot of variability on how elevated potassiums are tolerated by clinicians. Hear experiences from the field on how many different practices view what too high a potassium is and how and when it gets treated prior to weaning from bypass.

The de novo use of Del Nido cardioplegia in adult cardiac surgery has gained in popularity, many variations to the original Del Nido formula have come into vogue. Is this a safe cardioplegia strategy? Does Del Nido save time and expense for routine CABG or valve surgeries? Hear some great discussions from practicing clinicians that are familiar and also use the Del Nido cardioplegia formula.

Controversies in perfusion and cardiac surgery are commonplace. This program explores the controversial topic of transfusion and the lowest acceptable hematocrit on pump. The panel also discusses ultrafiltration, flow rates, and RAPP.

Cardiac surgery procedures usually involve the use of cardiopulmonary bypass and cardiac arrest. In consequence, myocardial protection is essential. Inadequate protection may cause myocardial stunning, cell apoptosis, and infarction. The search for an ideal cardioplegic solution has continued since the very beginning of cardiac surgery. Plenty of solutions are available, both commercial and self-made. Yet, there are no guidelines referring to the use of a specific solution, and the literature does not clearly confirm the superiority of one over another.

Controversies in Perfusion, Blood Transfusions

Christine Perme, PT, CCS, FCCM discusses the physical therapy of long-term ECMO patients. Christine and the panel give examples of and discuss ambulating our ECMO patients to maintain their muscle tone and balance.

Dr. Prakash Balan lectures and discusses the latest outcomes data on TransCatheter Valve Replacement (TAVR) Vs. Surgical Aortic Valve Replacement (SAVR) Dr. Balan presents several case studies and engages in a lively debate about patient selection, overuse, and presents his views in support of TAVR as a first-line option for patients in the low-risk group.

Joe presents data on the commonality of clot burden in the ECMO circuit and how difficult it is to detect without a tool that can directly measure intra-oxygenator volume in order to detect trends over time indicating your oxygenator is filling with clot. Joe discusses the only currently available tool for this purpose, the Transonic ELSA meter. This technology is an important early warning system regarding the health of you oxygenator and also an indicator about the effectiveness of your anticoagulation strategy.

Tammy Sparacino, CCP lectures on non or minimally invasive cardiac output devices. The panel discusses the advantages and challenges that these devices pose in regards to accuracy and dependability, especially in artificial circulatory support and ECMO.

Dr. Hany Samir and a panel of experienced perfusionists describe and discuss ECMO cannulation strategies for ARDS, Cardiac Failure or full CardioPulmonary support. The panel provides case studies and explores exotic cannulation strategies for patients requiring greater than usual support. The faculty/panel discuss and show examples of single and double cannulation techniques for VV ECMO.